Blunted endoscopic instrument



March 22, 193 8. F. c. WAPPLER BLUNTED ENDOSCOPIC INS TRUMENT FiledSept. 19, 1934 INVENTOR,

W M, W

'of the fenestra;

Patented Mar. 22, 1938 anzpst FATE "i" OFFEQE 2 Claims.

My present invention relates generally to surgical'instruments, and hasparticular reference to a new and improved endoscopic instrument.

While I have herein illustrated my invention in the form of an endoscopedesigned primarily for inspection and treatment of the vaginal vault andcervix of small girls, it will be understood that the invention isapplicable broadly to any type of endoscopic instrument designed forinsertion into a constricted body cavity. 7

One of the main objects is to provide a compact and especially smalldevice Whose insertion into small passages is capable of accomplishmentwith a maximum amount of ease and safety.

The instrument is of the type which consists, essentially, of anendoscopic tube having an open forward end out along a diagonal, therebydefining an elongated fenestra arranged obliquely with respect to thetube axis. One of the primary objects of the present invention is toprovide an improved means for blunting this type of endoscopic tube sothat it may-be inserted into abody passage without an obturator, yetwith safety.

The instrument includes a telescope which commands a forwardly obliquefield of vision out and since the instrument is rather small to startwith, and is primarily intended for insertion into narrow cavities, itis essential that the illumination of the field be maintained at amaximum and that the field of vision be as large as possible. It is alsohighly desirable that the external calibre of the instrument be as smallas possible. One of the desirable objects which my present inventionachieves consists in the provision of a means for effectually bluntingthe instrument in a manner which does not reduce the lumen of the tubeor increase the calibre of the instrument.

Briefly, the endoscopic tube of the present invention has the forwardend of its longest wall rounded and inwardly thickened; and on each ofthe side edges of the oblique fenestra I provide a ridge which aids inblunting the tube. In accordance with my invention, these ridges areexternal, i. e., on the outer surface of the tube, whereby the lumenremains unimpaired; and the ridges not only taper toward the rear butterminate short of the rear edge of the fenestra, whereby the calibre ofthe instrument is not increased. The blunting of the forward end of thelongest wall, per se, is disclosed in Wappler Patent Number 1,703,216,issued February 26, 1929.

In accordance with the general object of compactness, the presentinstrument is also provided with an efficient and simplified means forguid,

inga catheter, electrode, or similar tool through the tube so that itsforward end may be projectcdinto the illuminated field of vision.

I achieve the foregoing objects, and such other objects as mayhereinafter appear or be pointed out, in the manner illustrativelyexemplified in the accompanying drawing, wherein- Figure 1 is a sideview of an instrument embodying the features of my present invention;

Figure ,2 is a bottom view of the same;

Figure 3 is a cross-sectional view through the tube alone, takensubstantially along the line 33 of Figure 1;

Figure 4 is a viewsimilar to Figure 3, taken substantially along theline 4-4 of Figure 1;

Figure 5 is an enlarged view taken along the direction 55 of Figure 1,showing the construction of the tube itself; and

Figure 6 is an enlarged cross-sectional view taken substantially alongthe .line 6-6 of Figure 2.

The endoscopic tube It) is substantially oval in cross-section, asindicated most clearly in Figure 3, andis associated at its rear endwith a collaril and. with the irrigation petcocks l2 and I3. 2

The wall of the tube merges at its .rear end with the curved cathetherguide l4 through which a catheter, electrode, or similar instrumentalitymaybe inserted.

A threaded bearing member I5 is removably screw-threaded into the collarII and is provided with an opening through which the body portion :ofatelescope it may be removably inserted. The telescope is preferably ofthe character illustrated and described in Patent Number 1,680,491,dated August 14, 1928, the rear end carrying the usual eyepiece H, theinsulation rings l8, and conductiveareas to which electrical connectionsmay be made. A pin l9 may be conveniently provided for engagement withan opening in the collar ll, so that the proper positioning of thetelescope will be assured when it is inserted into the tube In.

The forward end of the tube I0 is cut on a diagonal, thereby defining anoblique fenestra which is elongated and which lies in a plane forming anangle of about with the tube axis. The telescopeis adapted to positionitself along the long wall of the tube II], and terminates in a lampextension 20 carrying a miniature lamp bulb 2|. Behind the extension 20an objective lens 22 is mounted, commanding a forwardly oblique field ofvision whose boundaries are approximately designated by the dot-and-dashlines 23 of Figure 6.

On the inner surface of the telescope, just behind the objective 22 andadjacent to the rear edge 2% of the fenestra, I provide an oblique fixedprojection 25 whose function it is to deflect outwardly a. catheter 25or similar tool that is inserted along the short wall of the tube I!) byadvancing it forwardly into the catheter guide I l. The manner in whichthis tool extends along the short wall of the tube, and is deflectedoutwardly into the field of vision, is shown most clearly in Figure 6.

In accordance with my present invention, the forward end of the longwall of the tube is rounded and inwardly thickened, as indicated at El,whereby the forward tip of the instrument is effectually blunted andrendered harmless. Without this thickening or blunting, the forward tipof an obliquely cut tube of the present character would be dangerouslysharp and likely to cause injury during insertion of the instrument.

Preferably, the thickening 21 is provided on its inner surface with alongitudinal groove 28' adapted to accommodate the lamp 2| of thetelescope. This grooveway is not absolutely essential, the essence ofthe arrangement lying primarily in the fact that the forward tip of thetelescope is positioned behind, and thereby shielded by, the roundedthickened forward end of the tube.

The side edges of the oblique fenestra are also inherently dangerous,especially where the instrument is to be inserted into very smallcavities having delicate membranes. To aid in blunting the instrument,the present invention provides external ridges 29 arranged,respectively, along the side edges of the fenestra. By arranging theseridges on the external surface of the tube, the lumen of the tuberemains unimpaired, and the field of vision of the telescope is therebyas great as the size of the fenestra permits.

Each of the ridges 29 purposely tapers off toward the rear andterminates short of the rear edge 24 of the fenestra, This constructionis illustrated most clearly in Figure 5, and the result is that theexternal calibre of the instrument remains unincreased. Thus, thecalibre of the instrument is determined by the external cross-sectionalong substantially the line 3-3 of Figure l. The cavity into which theinstrument is inserted must be stretched to a cross-sectional areasufficient to permit passage of this cross-section of the tube, shownmost clearly in Figure 3. If the ridges 29 were extended around the rearedge 26 of the fenestra, or if they were not properly tapered off orterminated short of this rear edge, the calibre of the instrument wouldbe in creased. The reason why the external ridges 29 do not increase thecalibre of the instrument, in accordance with the present construction,is most clearly depicted in Figure 4. It will be observed that thethickening of the tube adjacent to the side edges of the fenestracommences only at a point forwardly of the rear edge 24, as indicated inFigure 4, at which the obliqueness of the fenestra has already served toreduce the calibre of the instrument. Proceeding forwardly, the ridges29 may become thicker and thicker, without increasing the calibre of theinstrument, because the oblique arrangement of the fenestra causes agradual reduction of the calibre toward the front.

While the present arrangement leaves the rear edge 24 unblunted, this isnot of material importance, because this rear edge is not a dangerousedge in any event; and during the insertion of the instrument thelateral stretching of the cavity wall by the ridges 29 serves to guidethe tissues smoothly and safely over the rear edge 24.

The illustrated embodiment of the present invention is extremely compactand efficient. Its working length is only 3 inches, and its calibreapproximately 13 French. It has proven to be extremely convenient andeffective in the examination of the entire female urethra, as well as ofthe anterior portion of the male urethra. When used in the vagina, alarge rubber disc is preferably employed to seal the vaginal vault,whereby the proper distention by fluid may be accomplished.

The ease of manipulation of the present instrument is greatly enhancedby the fact that no obturator is necessary for introduction into thecavity. The entire instrument, with the telescope in place, and withcatheter or electrode slightly retracted, may be introduced bodily withmaximum safety.

The use of the instrument is especially indicated in cases of gonorrhealendocervicitis in infants and children, and it is useful generally instudying and treating various pathological conditions such as cysts,polyps, papillomatous masses, etc. 0

It will be understood, however, that the blunted arrangement of thepresent invention and the desirable results achieved thereby are notrestricted to any specific type of instrument or to any particular uses.

In general, it will be understood that changes in the details, hereindescribed and illustrated for the purpose of explaining the nature of myinvention, may be made by those skilled in the art without departingfrom the spirit and scope of the invention as expressed in the appendedclaims. It is, therefore, intended that these details be interpreted asillustrative, and not in a limiting sense.

Having thus described my invention, and illustrated its use, what Iclaim as new and desire to secure by Letters Patent is l. A telescopefor insertion into a fenestrated endoscopic tube, said telescope beingprovided with an objective which commands a forwardly oblique field ofvision, and an oblique projection integrally formed on the telescopewall immediately behind said objective and adapted to deflect into saidfield a catheter inserted through said tube alongside of the telescope.

2. A blunted endoscopic instrument adapted to be safety inserted into aconstricted body cavity without obturation of the instrument, comprisinga tube with an open forward end defining a fenestra which lies in aplane oblique to the tube axis, a telescope arranged within the tubealong the longest wall of the latter and commanding a forwardly obliqueview out of said fenestra, an external ridge on the tube alongside ofeach of the side edges of the fenestra and terminating short of the rearedge of the fenestra, and an oblique projection on the inner surface ofthe telescope adjacent to the rear edge of the fenestra, said projectionserving to deflect outwardly a catheter inserted through the tube alongits shortest wall.

FREDERICK CHARLES WAPPLER.

